Testicular Cancer

Testicular cancer is the most common solid tumor affecting young men between the ages of 15 and 35 years old.  It’s important to know it only affects 1-2% of sex-assigned at birth males worldwide.  In the United States it is estimated that there are over 9,000 new cases of testicular cancer each year.

This health guide will give you some basic facts about testicular cancer.

What is testicular cancer?

Testicular cancer is cancer of the testicle.  The most common type of testicular cancer is a germ cell tumor.

Who is at risk of testicular cancer?

Anyone with testicles (or testes) is at risk of testicular cancer.  Things that can increase someone’s risk of testicular cancer include:

  • A history of an undescended testicle (known as cryptorchidism)
  • Family history of testicular cancer
  • Having testicular cancer before
  • Having Klinefelter Syndrome
  • A history of gonadal dysgenesis, which means the testicles did not develop appropriately

The risk of testicular cancer may also be affected by race and ethnicity.  In the United States, testicular cancer is more than 4 times more common in people who identify as White than those who identify as Black.  Those who identify as Latinx, Asian/Pacific Islander, and Native American are somewhere in between.

What symptoms are associated with testicular cancer?

For most people testicular cancer will present as a painless mass, lump, or swelling in their scrotum (sac that holds the testicles).

Symptoms of testicular cancer may include:

  • A painless lump or swelling in a testicle
  • A dull ache or feeling of heaviness in the lower abdomen, scrotum, or area around the anus (or rectum)
  • Pain in the scrotum or testicle
  • A change in how the testicle feels

If the testicular cancer has spread, or metastasized, it can present with other symptoms.

What should I do if I have a lump or swelling in my scrotum?

Whenever you notice a new lump or swelling in your scrotum it’s important to see your health care provider for an appointment.

Your health care provider will perform a testicular exam.  During the testicular exam they will inspect your penis and testicles.  They will then use gloved hands to examine your testicles for any lumps, bumps, or swellings.

If your health care provider notices a lump or swelling in your scrotum they may get:

  • A testicular ultrasound (uses sound waves to take images of your testicles and the blood flow)
  • Blood tests to check for signs of cancer
  • Urine test to check for sexually transmitted infections

What happens if I have testicular cancer?

Any cancer is a challenging diagnosis.  Testicular cancer is very treatable.  In fact, with treatment it has over a 95% percent five-year survival rate.

If you have testicular cancer, your health care provider will work with a team of cancer specialists (or oncologists) and urologist (surgeon that specializes in the urinary and male reproductive systems) to help with your treatment.  They will also get some more tests including:

  • Blood tests
  • Imaging studies (such as a chest X-ray and imaging of your pelvis and abdomen) to see if the cancer has spread

How is testicular cancer treated?

Testicular cancer treatment depends on the type and severity of the cancer.  Treatment always includes an orchiectomy (which means surgical removal of the affected testicle).  This helps confirm the diagnosis and remove the cancer.   Depending on your type and severity of testicular cancer you may also have chemotherapy and/or radiation therapy.

It’s important to talk to your medical team about impacts on fertility (the ability to have biological children in the future).  This can include a discussion around sperm banking (storing your sperm).

It’s also important to find supports.  Some people find supports with family and friends, their medical team, a professional therapist, and/or a support group of people with testicular cancer.

What can I do to prevent testicular cancer?

While there’s no way to prevent testicular cancer, you can perform testicular self-exams to try to catch it early.  Testicular exams should be done in a private space.  Some people like to do them in the shower, and other people find it helpful to do in front of a mirror.  While there is no set recommendation on how frequently to perform a testicular self-exam, consider starting with monthly exams to get into the habit.

To perform a testicular self-exam:

  • Look at your scrotum. Check to see if you notice any swelling in your scrotum.
  • Examine each testicle. Use both hands and place your thumb on top of your testicle and your index and middle fingers underneath. Gently roll your testicle between your fingers and feel for bumps.

If you notice a new, hard bump or swelling in your testicle you should call your health care provider to set up an appointment.

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